Queen's University Council
Reception and Dinner
Saturday, May 5, 2012
Registration Form

I will attend the University Council Dinner($40.00/person)
7:00pm
Ban Righ Dining Hall(cash bar)

I am putting my cheque, in the mail (preferred method of payment)(cheques may be post-dated to May 5, 2012)
Please send cheques, made payable to Queen's University to:
University Secretariat, 153 Richardson Hall, Queen's University,
Kingston, ON K7L 3N6

I will pay by cash or cheque that day

OTHER INFORMATION:

University Council Dinner - I will be accompanied by:

Please advise us of any special dietary needs:

Additional Questions/Comments

Name:(required)
(Please type your name the way you wish it to appear on your nametag)

Internal Journal Entries credit account 10000 55599 699018 50045. (Please send a copy of the journal to the University Secretariat).